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doi: 10.2147/JIR.S152835 [DOI] [PMC free article] [PubMed] [Google Scholar] 51

Clinicians should also consider alternative medical explanations for new-onset fatigue, including thyroid dysfunction, anemia, sleep apnea (which may improve or persist despite weight loss), chronic kidney disease, or cardiovascular conditions

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Of these, upregulations in phosphofructokinase and pyruvate kinase are of particular note, as these represent rate-limiting catalytic steps within the glycolytic pathway, which is a described result of GLP-1 receptor stimulation that ultimately results in augmented ATP production